Indiana
Professional Licensing Agency
ROY ELMER KINGMA
Controlled Substance Registration - Physician
License number
01020470B
Date granted
05/31/1986
Date expires
10/31/2013
Class
Controlled Substance Registration - Physician
Status
Expired Non-Renewable
Address
12387 Sandalwood Drive, Demotte IN 46310
indianalicensing.org
ID 5843598
LAST UPDATED 2024-04-21 06:14:48 UTC
LAST UPDATED 2024-04-21 06:14:48 UTC
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